CKD Progression and Mortality among Hispanics and Non-Hispanics

Fischer, Michael J.; Hsu, Jesse Y.; Lora, Claudia M.; Ricardo, Ana C.; Anderson, Amanda H.; Bazzano, Lydia A.; Cuevas, Magdalena; Hsu, Chi‐yuan; Kusek, John W.; Renteria, Amada; Raj, Dominic S.; Rosas, Sylvia E.; Pan, Qiang; Yaffe, Kristine; Go, Alan S.; Lash, James P.

doi:10.1681/asn.2015050570

Cited by 46 publications

(40 citation statements)

References 42 publications

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“…Odds ratios were calculated per 1 SD deviation decrease in subscale score. Based on existing literature, potential confounding variables included age, sex, education, income, insurance status, Hispanic/Latino background, hypertension, diabetes, eGFR, and albuminuria ( Lora et al, 2011 ; Lora et al, 2009 ; Norris and Nissenson, 2008 ; Hemmelgarn et al, 2010 ; Fischer et al, 2016 ). We evaluated age, sex, and education as effect modifiers of the association between acculturation and kidney function.…”

Section: Methodsmentioning

confidence: 99%

Acculturation and chronic kidney disease in the Hispanic community health study/study of Latinos (HCHS/SOL)

Lora

Ricardo

Chen

et al. 2018

Preventive Medicine Reports

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Hispanics/Latinos are burdened by chronic kidney disease (CKD). The role of acculturation in this population has not been explored. We studied the association of acculturation with CKD and cardiovascular risk factor control. We performed cross-sectional analyses of 13,164 U.S. Hispanics/Latinos enrolled in the HCHS/SOL Study between 2008 and 2011. Acculturation was measured using the language and ethnic social relations subscales of the Short Acculturation Scale for Hispanics, and proxies of acculturation (language preference, place of birth and duration of residence in U.S.). CKD was defined as estimated glomerular filtration rate (eGFR) <60 ml/min/1.73 m2 or urine albumin-to-creatinine ratio ≥ 30 mg/g. On multivariable analyses stratified by age, lower language subscale score was associated with higher odds of CKD among those older than 65 (OR 1.29, 95% CI, 1.03, 1.63). No significant association was found between proxies of acculturation and CKD in this age strata. Among individuals aged 18–44, a lower language subscale score was associated with lower eGFR (β = −0.77 ml/min/1.73 m2, 95% CI −1.43, −0.10 per 1 SD increase) and a similar pattern was observed for ethnic social relations. Among those older than 65, lower language subscale score was associated with higher log-albuminuria (β = 0.12, 95% CI 0.03, 0.22). Among individuals with CKD, acculturation measures were not associated with control of cardiovascular risk factors. In conclusion, lower language acculturation was associated with a higher prevalence of CKD in individuals older than 65. These findings suggest that older individuals with lower language acculturation represent a high risk group for CKD.

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Section: Methodsmentioning

confidence: 99%

Acculturation and chronic kidney disease in the Hispanic community health study/study of Latinos (HCHS/SOL)

Lora

Ricardo

Chen

et al. 2018

Preventive Medicine Reports

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“…Two studies reported higher risk of CKD progression for Pacific Islanders -1 study reporting adjusted OR (95% CI): 1. [15,25,26,31,38,52]. One study reported similar risk [9].…”

Section: Pacific Islandersmentioning

confidence: 97%

“…Overall, most (n = 24) studies reported higher risk of CKD progression in African-American/Afro-Caribbean [13][14][15][16][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35][36][37][38]. However, some (n = 12) studies found no significant ethnic differences in risk of CKD progression, which may be partly due to smaller study sample size, duration of follow up, and/or adjustment for confounders and mediators [9,[38][39][40][41][42][43][44][45][46][47][48]. Studies adjusted for demographics factors (such as age and sex, with fewer studies adjusting for socioeconomic status), biological factors (such as baseline estimated glomerular filtration (eGFR) levels, proteinuria, baseline creatinine, cholesterol, haemoglobin, blood pressure), comorbidities (hypertension, diabetes, cardiovascular disease).…”

Section: Ethnic Differences In Ckd Progression African-americans and mentioning

confidence: 99%

Ethnic minority disparities in progression and mortality of pre-dialysis chronic kidney disease: a systematic scoping review

et al. 2020

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Background: There are a growing number of studies on ethnic differences in progression and mortality for predialysis chronic kidney disease (CKD), but this literature has yet to be synthesised, particularly for studies on mortality. Methods: This scoping review synthesized existing literature on ethnic differences in progression and mortality for adults with pre-dialysis CKD, explored factors contributing to these differences, and identified gaps in the literature. A comprehensive search strategy using search terms for ethnicity and CKD was taken to identify potentially relevant studies. Nine databases were searched from 1992 to June 2017, with an updated search in February 2020. Results: 8059 articles were identified and screened. Fifty-five studies (2 systematic review, 7 non-systematic reviews, and 46 individual studies) were included in this review. Most were US studies and compared African-American/Afro-Caribbean and Caucasian populations, and fewer studies assessed outcomes for Hispanics and Asians. Most studies reported higher risk of CKD progression in Afro-Caribbean/African-Americans, Hispanics, and Asians, lower risk of mortality for Asians, and mixed findings on risk of mortality for Afro-Caribbean/African-Americans and Hispanics, compared to Caucasians. Biological factors such as hypertension, diabetes, and cardiovascular disease contributed to increased risk of progression for ethnic minorities but did not increase risk of mortality in these groups. Conclusions: Higher rates of renal replacement therapy among ethnic minorities may be partly due to increased risk of progression and reduced mortality in these groups. The review identifies gaps in the literature and highlights a need for a more structured approach by researchers that would allow higher confidence in single studies and better harmonization of data across studies to advance our understanding of CKD progression and mortality.

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“…[10,11] They account for a nearly 40% higher prevalence rate of ESKD than non-Hispanic whites and may experience increased risk of progression to ESKD. [12] , [13] In the Hispanic Community Health Study/Study of Latinos (HCHS/SOL), a prospective study of over 16,000 individuals throughout the U.S., the prevalence of CKD in all women (aged 18-74 years) was 13% and disease unawareness for men and women combined reached 18%. [14] Given the above, disease unawareness and lack of treatment could be particularly detrimental for Hispanic/Latino women of reproductive age.…”

Section: Introductionmentioning

confidence: 99%

Infertility and Pregnancy Loss in Hispanic/Latino Women with Chronic Kidney Disease: Results from the Hispanic Community Health Study/ Study of Latinos (HCHS/SOL)

Reynolds

Loehr

Hogan

et al. 2020

Preprint

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Background: Hispanic/Latino individuals are less likely to receive optimal treatment for chronic kidney disease (CKD) than non-Hispanic whites. This may be particularly detrimental for women of reproductive age as CKD may increase risk for infertility, menstrual irregularities, and pregnancy loss. While these maternal outcomes have been associated with advanced CKD, their occurrence in mild to moderate CKD is unclear. Methods: Using baseline (2008-2011) and second study visit (2014-2017) data from the Hispanic Community Health Study/Study of Latinos (HCHS/SOL), we assessed the association between CKD and self-reported infertility, cessation of menses, hysterectomy, and nonviable pregnancy loss (experienced at less than 24 weeks gestation) in women of reproductive age (18-45 years). Multivariable survey logistic regression analyses were used to compute prevalence odds ratios with 95% confidence intervals (OR, 95% CI). Results: Of the 2,589 women included (mean age 31.4 years), 4.6% were considered to have CKD. In adjusted analyses, women with CKD did not have a significantly increased odds of infertility (OR 1.02, 95% CI 0.42 - 2.49), cessation of menses (OR 1.25, 95% CI 0.52 - 3.04) or hysterectomy (OR 1.17, 95% CI 0.61 - 2.25) compared to those without CKD. In those with CKD, the adjusted odds of a nonviable pregnancy loss was increased when considering pregnancies occurring after baseline visit (OR 2.11, 95% CI 0.63 - 7.02) but not statistically significance. Conclusion: In our Hispanic/Latino cohort, the presence of mild to moderate CKD did not confer an additional risk of our outcomes of interest. Examining nonviable pregnancy loss after CKD diagnosis in a larger sample warrants further study.

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CKD Progression and Mortality among Hispanics and Non-Hispanics

Cited by 46 publications

References 42 publications

Acculturation and chronic kidney disease in the Hispanic community health study/study of Latinos (HCHS/SOL)

Acculturation and chronic kidney disease in the Hispanic community health study/study of Latinos (HCHS/SOL)

Ethnic minority disparities in progression and mortality of pre-dialysis chronic kidney disease: a systematic scoping review

Infertility and Pregnancy Loss in Hispanic/Latino Women with Chronic Kidney Disease: Results from the Hispanic Community Health Study/ Study of Latinos (HCHS/SOL)

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